Document Detail


Prophylactic treatment after myocardial infarction in primary care: how far can we go?
MedLine Citation:
PMID:  12509367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite best practice, it may not be achievable in some patients to reach the optimal goals of secondary prevention recommendations for various reasons, such as co-morbidity, contraindications for some drugs or side effects. OBJECTIVE: Our aim was to estimate the achievable standards for audit purposes in primary care for prophylactic treatment of secondary prevention of myocardial infarction. METHODS: We conducted a survey of consecutive patients with a hospital diagnosis of first acute myocardial infarction during 1997 who were identified from discharge books from four hospitals and interviewed at their primary health centre 2 years after admission. The achievable standard for a prophylactic drug was then defined as the proportion of patients that could benefit from the treatment excluding those that for one justified reason or another were off medication. RESULTS: Three hundred and sixty-nine patients were interviewed in the follow-up. Aspirin or another antiplatelet regimen was prescribed in 86.9 patients, beta-blockers in 50.2%, angiotensin-converting enzyme (ACE) inhibitors in 32.5% and lipid-lowering drugs in 52%. The estimated achievable standards for those prescribed drugs were 94.5, 71,8, 50.5 and 69.8%, respectively. CONCLUSIONS: There is an underuse of prophylactic drug therapies after myocardial infarction. The standards established in this study for secondary preventive drug treatment might be achieved through a reasonable effort by GPs working in primary care committed to improving the quality of care.
Authors:
Carlos Brotons; Gaietà Permanyer; Valeria Pacheco; Irene Moral; Aida Ribera; Purificación Cascant; Josep Pinar;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Family practice     Volume:  20     ISSN:  0263-2136     ISO Abbreviation:  Fam Pract     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-01     Completed Date:  2003-05-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8500875     Medline TA:  Fam Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  32-5     Citation Subset:  IM    
Affiliation:
Unit of Clinical Epidemiology and Hospital/Primary Care Research Unit-Cardiology Department, Hospital General Universitari Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Spain. cbrotons@eapsardenya.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Drug Utilization*
Female
Guideline Adherence
Humans
Male
Medical Audit
Middle Aged
Myocardial Infarction / drug therapy*,  epidemiology,  prevention & control*
Physician's Practice Patterns*
Practice Guidelines as Topic
Primary Health Care / standards*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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